Regional Variation in the Predictive Validity of Self-Rated Health for Mortality.

Journal Article (Journal Article)

Self-rated health (SRH) is a commonly used measure for assessing general health in surveys in the United States. However, individuals from different parts of the United States may vary in how they assess their health. Geographic differences in health care access and in the prevalence of illnesses may make it difficult to discern true regional differences in health when using SRH as a health measure. In this article, we use data from the 1986 and 1989-2006 National Health Interview Survey Linked Mortality Files and estimate Cox regression models to examine whether the relationship between SRH and five-year all-cause mortality differs by Census region. Contrary to hypotheses, there is no evidence of regional variation in the predictive validity of SRH for mortality. At all levels of SRH, and for both non-Hispanic white and non-Hispanic black respondents, SRH is equally and strongly associated with five-year mortality across regions. Our results suggest that differences in SRH across regions are not solely due to differences in how respondents assess their health across regions, but reflect true differences in health. Future research can, therefore, employ this common measure to investigate the geographic patterning of health in the United States.

Full Text

Duke Authors

Cited Authors

  • Berchick, ER; Lynch, SM

Published Date

  • December 2017

Published In

Volume / Issue

  • 3 /

Start / End Page

  • 275 - 282

PubMed ID

  • 28983501

Pubmed Central ID

  • PMC5624545

Electronic International Standard Serial Number (EISSN)

  • 2352-8273

International Standard Serial Number (ISSN)

  • 2352-8273

Digital Object Identifier (DOI)

  • 10.1016/j.ssmph.2017.01.010


  • eng